Provider Demographics
NPI:1356093520
Name:WHITEHOUSE, ERIN MARIE (PMHNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:WHITEHOUSE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 TIMBERLINE ST
Mailing Address - Street 2:
Mailing Address - City:VILLA HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1065
Mailing Address - Country:US
Mailing Address - Phone:513-846-1243
Mailing Address - Fax:
Practice Address - Street 1:1353 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2065
Practice Address - Country:US
Practice Address - Phone:855-591-0092
Practice Address - Fax:502-637-9660
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017136363LP0808X
OH0030495363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health